RANGE OF PATIENTS

Galen’s Clientele

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Eudemus was a member of the urban cultural elite, and Galen’s care in his case established the physician’s reputation as the preeminent doctor in Rome. While his roster included many society patients—aristocrats, orators, senators, emperors, as well as their wives and children—Galen treated people from diverse social classes. High society may have been Galen’s milieu, but the lives of peasants were not at a far remove: in the course of his travels, often on foot, Galen frequently interacted with people in the countryside.

A shepherd and goats, detail from the “Four Seasons” mosaic. Roman, ca. 325 CE. Marble, limestone, and glass. Daphne, near Antioch (present-day Antakya, Turkey). Musée du Louvre: Ma 3444. Photo: © RMN-Grand Palais / Art Resource, NY.

He describes treating their injuries and writes with admiration about their well-conditioned bodies and self-sufficiency. Galen saw peasants as physically distinct from their well-to-do counterparts—their way of life, their diets, as well as their “hard bodies”—and often prescribed treatments that would have been too harsh or disgusting for the “soft bodies” of his urban patients. Although there is no question that Galen saw peasants as different, he brought the same quality of care to rural communities as he did to Rome’s elites. He recommended remedies that were better suited to a peasant constitution: prescriptions such as urine and dung did not signal a lower quality of care, but instead revealed resourcefulness in finding the best means of treatment available at hand. Galen appears never to have been dismissive of peasants, and he documented their cases with the same attention and intensity as he did his wealthier patients. 

In Galen’s writings, the social class of a patient surfaces only if it is medically relevant. The same tendency that one notes in his descriptions of peasants is true throughout his narratives: in Galen’s case histories, he mentions a patient’s social status or profession because it explains a symptom, the cause of an injury, or a relevant physical quality, or for some other scientifically notable reason. Sometimes a person’s occupation is of central importance—the snake-bitten snake catcher, for example—while in other instances, Galen never even reveals a patient’s job or class. 

Galen also treated enslaved people. Once again, a patient’s free or enslaved status is typically mentioned only if it is medically relevant, as in the case of an injured slave wounded by a beating from his master.

A slaveholder beating an enslaved person, detail from the “Great Hunt” mosaic. Early 4th century CE. Villa Romana del Casale, Piazza Armerina, Sicily. Photo: Ian Rutherford / Alamy Stock Photo.

In some instances, we may learn that a particular patient was enslaved through contextual narrative elements; yet in many other cases, it is impossible for us to know if a patient was enslaved or free. In Galen’s world, enslaved people practiced almost every occupation, so the snake-bitten snake catcher may have been enslaved, but it would not have been medically relevant, so this information is not given. Galen does occasionally describe enslaved people in unflattering, stereotypical terms—disloyal, thieving, lazy—but he also expresses the view that an owner should control his or her anger and refrain from violence toward them. Nevertheless, Galen’s treatment of enslaved people was presumably less altruistic than his treatment of peasants: in the eyes of the law and of society at large, he was providing a service for their owners as much as for the enslaved themselves, since the latter were classed as property. Galen himself owned enslaved people: he had household staff on his estates as well as assistants, and in keeping with the practices of his day, he listed his slaves on inventories of his possessions. But as far as patients were concerned, Galen believed that everyone should have access to medical expertise, including the enslaved, and, as always, he provided the highest standard of care. 

We do not know definitively what class of people made up the majority of Galen’s medical practice, but it is certain that his patient population was diverse. He made house calls, especially for his wealthier, more pampered clients, but he also operated a clinic out of his private residence, which seems to have been open to all.

Galen was not the only doctor to operate a clinic in the Roman world. The House of the Surgeon in Pompeii, for example, provides archaeological evidence of such clinics.

Left: Giovanni Battista Piranesi. Cut-aways of the House of the Surgeon, Pompeii. Etching. H. 36.0 cm; W. 53.9 cm. From Francesco Piranesi, Antiquités de la Grande Grèce aujourd’hui Royaume de Naples, Vol. 1: Antiquités de Pompeïa (Paris, 1804), pl. XV. Photo: Universitätsbibliothek Heidelberg. Public domain. Right: House of the Surgeon, Pompeii. Roman, 4th–3rd century BCE. Limestone. Photo: Filippo Bucciarelli / History of Medicine Topographical Database.

Patients would drop by or be carried over, and Galen treated everyone regardless of their ability to pay. This was true both close at home and far away: he even treated patients in distant countries by mail, an ancient, albeit much slower, version of telemedicine. When discussing a particular eye ailment, Galen writes:

“I have not only [personally] treated persons suffering from this ailment but through correspondence I have cured some patients residing in other countries. Some sent me letters from Iberia [Spain and Portugal], from Celtic lands, from Asia, Thracia [the Balkans] and other countries, asking me whether I knew and could dispatch a trustworthy medicine.”

Where there was need, Galen was ready.